I would like to wish everyone a Happy Thanksgiving!  I hope you have enjoyed my articles and blog posts this past year, and there will be more to come in 2014!

The mitochondria have a number of important functions in a cell, and the most well known function involves the production of Adenosine triphosphate, which is also known as ATP.  In fact, most of the ATP is generated inside of the mitochondria.  ATP is created from the breakdown of carbohydrates and fats, and involves a process known as oxidative phosphorylation.  The goal of this post isn’t to discuss in detail the function of the mitochondria, but instead is to demonstrate how important they are to one’s thyroid health, and overall health as well.

But why is ATP important?  In addition to its well established role in cellular metabolism, extracellular ATP and its breakdown product adenosine exert pronounced effects in a variety of biological processes including neurotransmission, muscle contraction, cardiac function, platelet function, vasodilatation and liver glycogen metabolism (1).  ATP also plays an important role in DNA and RNA synthesis (2).

Certain coenzymes are important for the formation of ATP.  In order for these coenzymes to work efficiently, they require an adequate supply of certain nutrients.  This is one of the many reasons why eating well is extremely important to one’s overall health.

Although the mitochondria are essential for life, they constitute the greatest source of reactive oxidants.  They also contain heavy metal ions such as iron and copper, and all of this favors the formation of free radicals.  Free radicals are molecules with unpaired electrons, and in this state they are very reactive and can cause damage to our cells.  Fortunately the body produces antioxidants to help prevent free radical damage, and of course many people get antioxidants in the food they eat and/or the supplements they take.

The primary cause of cell death is a depletion of cellular ATP.  Mitochondrial function does deteriorate as one gets older.  It was proposed that the maximal life-span is mainly an expression of the genetic control over the rate of oxygen utilization, and that the rate of mitochondrial damage produced by free radical reactions increases with increasing oxygen consumption, which ultimately causes cell death (3).  So while oxygen is of course necessary to survive, aerobic metabolism is what leads to the formation of these free radicals.

Other Factors Which Lead To Mitochondrial Damage

As I mentioned earlier, free radicals are produced by the mitochondria.  So essentially the free radicals produced by the mitochondria are responsible for their own damage.  How does this happen?  Well, during oxidative phosphorylation, normally all of the oxygen consumed is converted in mitochondria to something called the superoxide radical.  Superoxide is then transformed to hydrogen peroxide by certain enzymes.  When these enzymes are unable to convert the superoxide radical to hydrogen peroxide, this causes oxidative damage.  Mitochondrial damage in turn can lead to the development of inflammatory mediators, such as tumor necrosis factor alpha.

One also needs to keep in mind that certain nutrients are important for the mitochondria to function normally.  As a result, if someone eats a lot of refined foods and sugars, thus resulting in a deficiency of those nutrients important for mitochondrial function, then this can result in mitochondrial decay (4).

Certain toxins can also cause mitochondrial damage.  For example, one study showed that thimerosal-derived ethylmercury (which is used as a preservative in certain vaccines, skin test antigens, and tattoo inks), inhibits mitochondrial respiration and leads to an increase in the formation of superoxide (5).  The study found a five-fold increase in the levels of oxidant damaged mitochondrial DNA after Thimerosal treatment.

There is also evidence that certain pathogens can cause damage to the mitochondria.  For example, one study showed that Clostridium difficile can cause damage to the mitochondria (6).  However, this was conducted on hamsters, and it is unknown if the same effect takes place with humans.  There is also evidence that an H. Pylori infection can cause mitochondrial damage (7)

The Importance of Thyroid Hormone For The Health of The Mitochondria

It has been known for a long time that thyroid hormones act directly on mitochondria, and thereby control the transformation of the energy derived from oxidations into a form utilizable by the cell (8).  Those with hypothyroid conditions consume oxygen more slowly because the mitochondria respire slowly.  On the other hand, those with hyperthyroid conditions consume oxygen faster because the mitochondria consume oxygen faster.

One study I came across discussed how hyperthyroidism is associated with tissue oxidative injury (9).  In other words, hyperthyroidism can lead to an increase in mitochondrial damage.  However, the same study discussed how thyroid hormone can activate mitochondrial mechanisms which provide protection against tissue dysfunction.  So while having an excess amount of thyroid hormone isn’t a good thing for the health of the mitochondria, having healthy levels of thyroid hormone can help to protect the mitochondria from damage.

Another study I came across looked at the effect of thyroid hormone on the mitochondria (10).  The article discussed how thyroid hormone status has a profound impact on mitochondria, and that thyroid hormones stimulate mitochondriogenesis and increase cellular oxidative capacity.  So what this is saying is that thyroid hormone is important for the formation of mitochondria, and also increases the cells capacity to utilize oxygen.

How To Improve The Health Of The Mitochondria

I recently attended the International Conference on Human Nutrition and Functional Medicine, and they dedicated an entire day discussing how to improve the health of the mitochondria.  One of the presenters was Dr. Matthew Hirschey, and he spoke about how caloric restriction can help to improve the health of the mitochondria, which in turn can increase lifespan.  This has not yet been proven in humans, although it has been proven with many different species of animals.  So while one wants to eat well, it also is important not to overeat, which of course many people have a tendency to do.

During the presentation Dr. Hirschey spoke about how Okinawa, Japan has the world’s longest life expectancy, and a low rate of chronic health conditions which are related to the aging process.  Although genetics can play a role in this, Dr. Hirschey also mentioned how they tend to eat until they are 80% full, whereas it’s common for people who live in other countries (including the United States) to eat until they are close to 100% full.  This of course is common when going out to eat, as many people will start off with a high carbohydrate appetizer, have a big meal, and even though they are stuffed will “make room” for dessert.

Regular exercise is also important for optimal heath of the mitochondria.  It seems that an age-associated decline in mitochondrial function contributes to insulin resistance in the elderly (11), and studies have shown that there is a robust improvement in skeletal muscle mitochondrial content and function in response to an achievable program of moderate intensity physical activity (12). Another journal article discussed how the cardioprotective effects of exercise might be mediated, at least partially, by redox changes and include the up-regulation of mitochondrial chaperones, improved antioxidant capacity, and/or elevation of other protective molecules against cellular death (13).  More research needs to be done in this area, but the evidence is strong that engaging in moderate exercise on a regular basis improves the health of the mitochondria.

Certain nutritional supplements can also help to improve the health of the mitochondria.  Some of these include Acetyl-L-carnitine, CoQ10, resveratrol, lipoic acid, and omega 3 fatty acids.  This doesn’t mean that everyone should take all of these.  While I recommend for just about everyone to take an omega 3 fatty acid supplement, not everyone needs to take these other supplements I listed.  However, I do think it’s worth reading a blog post I wrote entitled “CoQ10 and Thyroid Health“, as many people with thyroid and autoimmune thyroid conditions have depleted CoQ10 levels.   There is also evidence that improving the vitamin D status of those with a vitamin D deficiency can help to improve mitochondrial oxidative function (14).

To summarize these findings, thyroid hormone is important for the health of the mitochondria.  As a result, someone with a hypothyroid condition will have problems with the production of ATP.  Remember that ATP is important for energy production, and so a decreased production of ATP can lead to a decrease in energy, which is quite common with hypothyroid conditions.  But as I mentioned earlier in this post, ATP is also important for proper neurotransmission, muscle contraction, cardiac function, platelet function, vasodilatation and liver glycogen metabolism.  And so having a hypothyroid condition can affect all of these functions. On the other hand, a hyperthyroid condition can lead to an increase in mitochondrial damage.  Some of the factors which can help to improve the health of the mitochondria include caloric restriction, regular exercise, and taking certain nutrients such as magnesium, fish oils, the B vitamins, vitamin C, lipoic acid, and CoQ10.  Obviously taking supplements isn’t a substitute for eating well, as eating a diet consisting of mostly whole foods while avoiding the refined foods and sugars is essential for optimal mitochondrial health.

Most people who consult with me for the first time are aware of the importance of eating a healthy diet.  Many of these people have already made some wonderful changes, as it’s not uncommon for me to consult with someone who is gluten free, dairy free, avoids refined foods and sugars, etc.  Of course there are also people who know they need to eat well, but haven’t yet made the necessary changes.

While people should strive to eat healthy most of the time, if someone begins a natural treatment protocol it is extremely important to be strict.  Every now and then in my articles and blog posts I discuss how I’ll indulge every now and then, as I’ll have a slice of pizza or dessert, or eat something else that I normally wouldn’t eat.  However, when I was diagnosed with Graves’ Disease and followed a natural treatment protocol I was very strict.  I began following a natural treatment protocol during the fall, which means that I eventually had to deal with the holiday season.  I also had a birthday during this time, and it admittedly was tough not having any birthday cake!

For those people following a natural treatment protocol in an attempt to restore their health back to normal, it is important to avoid the temptations that the holiday season might bring.  While many of the patients I work with do a great job of eating well, some people fall off the wagon as soon as Thanksgiving arrives, and many don’t get back on track until after the New Year.  I’ve had patients who were doing a wonderful job of following their diet for numerous months until the holiday season arrived.

Why Is It So Difficult For Many People To Eat Healthy During The Holiday Season?

One of the big problems with holidays such as Thanksgiving and Christmas is that many families and friends get together for meals.  This makes it extremely difficult to avoid the temptations, unless if perhaps you’re the host of these gatherings.  But even in this case this can be a challenge, as chances are most of your guests won’t be expecting a gluten free , low-carbohydrate meal, along with healthier dessert choices (i.e. fresh fruit).  Some people will prepare unhealthy foods for their friends and family members but will avoid eating them.  But for some people, it is very difficult to resist these foods.  If I had the temptation of pecan pie when I followed a natural treatment protocol I’m not sure if I would have been able to resist having a small piece!

Speaking of which, last year around Thanksgiving I had a couple of patients ask if it was okay to have a slice of gluten-free pecan pie.  If someone has just started a natural treatment protocol then it’s probably best for them to avoid these types of desserts, even if they are gluten free.  On the other hand, if someone can’t resist the pecan pie, then of course I’d prefer them to eat a gluten-free version.  But overall it’s best to stick with eating whole foods when someone is restoring one’s health back to normal.

But what about those people who have already restored their health back to normal?  Well, if someone has already restored their health back to normal and then eats a few bad meals or desserts during the holiday season this usually won’t cause a problem.  So for example, if someone eats some unhealthy food on Thanksgiving day, and then again at a holiday party, and one more time for a Christmas or Chanukah dinner, in most cases this won’t cause any long-lasting problems.  On the other hand, the person who eats junk food just about every day from Thanksgiving to New Years Day is more likely to encounter problems, and might even suffer a relapse.

What Can You Do To Avoid The Temptations?

When it comes to avoiding the temptations which come along with the holiday season, it really comes down to one’s mindset.  For example, I grew up eating mostly junk food, and even though I was eating much healthier before being diagnosed with Graves’ Disease, I was far from perfect.  But as I mentioned before, once I was diagnosed with Graves’ Disease I was pretty strict.  And the main reason for this was a change in my mindset, as I just told myself that I was going to do everything I could to restore my health back to normal, and this included avoiding junk food until I had restored my health.

For other people it might be a greater challenge to make these changes.  For example, if someone works at a corporate job where they constantly have junk food available for the holidays and/or have holiday parties, then this can admittedly be challenging.  Similarly, if you do dinner at the house of a family member or friend who prepares a dinner consisting of plenty of carbohydrates (i.e. mashed potatoes, pasta, pastries and other foods you should avoid), this also can be a challenge when you’re constantly around these foods.  Of course you can simply plan to stay home for the holidays, which I realize might mean breaking a tradition, but when it comes to your health it is worth it.

With the corporate job example it could be a greater challenge, as I don’t know of anyone who quit their job due to the constant exposure of unhealthy food during work.  However, in this case you just need to make the decision that you will avoid all of the temptations and do whatever is necessary to restore your health back to normal.  And if you need a little bit of motivation I’ll tell you a personal story that some people reading this have already heard.

When I was a student in chiropractic college I went on my first liver detoxification program under the guidance of another healthcare professional (my nutrition instructor from chiropractic school).  I forgot exactly how long the detoxification was for, but it was at least one month in duration, and I had to avoid all processed foods, and initially had to avoid eating meet.  So I was able to eat fruits, vegetables, nuts, and seeds, and I think a small amount of grains, although I can’t remember for sure.  This was pure torture for someone who was used to eating plenty of processed foods on a daily basis.  In any case, I attended chiropractic college right outside of Atlanta Georgia, and during the detoxification I wanted to attend a seminar which took place in Orlando Florida.  I went with a friend, whose parents lived in Daytona Florida.  And so on our way to Orlando we stopped by his parent’s house and spent the night there.

We arrived right around dinner time, and I remember his father saying  “Let’s go out for pizza”.  Just like many other people, I loved pizza (and still do).  And if there was one big weakness of mine, it was pizza!  To make a long story short, I went to the pizza place with my friend and his family, and I ate a plain salad (no dressing, no croutons, no parmesan cheese, no chicken) while everyone else was eating pizza.  I realize for many people this isn’t a big deal, but at that time it was extremely difficult for me to avoid this temptation.  The reason I brought up this story was to provide some motivation, as if I was able to avoid pizza that night, there is no question that anyone reading this can avoid the temptations of the holiday season (yes, even pecan pie!).

In summary, without question it can be a challenge to avoid eating junk food during the holiday season.  For those people following a natural treatment protocol, it is very important to try to eat well during this time.  But it also is important for those people trying to maintain their health.  In order to avoid these temptations, the best thing you can do is to change your mindset and make the decision that you are going to eat healthy, and under no circumstances will cheat.  And you also want to try your best to avoid those situations where you will be surrounded by these unhealthy foods.

It’s not uncommon for people experiencing symptoms indicative of a thyroid condition to have negative serum blood tests.  This includes the TSH, thyroid hormone levels (i.e. Free T3 and Free T4), thyroid antibodies, reverse T3, etc.  When someone mentions this to me then I’ll recommend for them to do other types of testing, such as testing the adrenals through the saliva, looking at secretory IgA to help evaluate the health of the immune system and gut, they can look at the hormones estrogen and progesterone, etc.  But what should one do when all of these tests are also negative?

The truth is that rarely is someone who has a thyroid or autoimmune thyroid condition negative with ALL of the different tests.  One problem is that these other tests can be costly, and most people can’t test for everything.  And quite frankly, there are dozens of different tests to choose from.  Here are some of the “alternative” tests available:

Adrenal testing through the saliva

Hormone testing (progesterone, estrogen, testosterone, etc.)

Hair mineral analysis

Parasitology profile

Pathogens profile

IgG Food Intolerance testing

Tests for toxins (BPA, PCBs, VOCs, heavy metals, chlorinated pesticides, etc.)

Iodine testing

Organic Acids

Amino Acids

Fatty Acids

Micronutrient testing

Neurotransmitters

Oxidative stress profile

Genetic Polymorphisms

Bacterial Overgrowth of Small Intestines

Intestinal Permeability

There are other tests besides the ones I listed, but the two points I want to make is that 1) most people won’t be able to afford to test for everything I listed here, and 2) it isn’t necessary to test for everything I listed.  If someone did obtain all of the testing I listed above, there is an excellent chance that we would find some values which were out of range.  This isn’t only true of people with thyroid and autoimmune thyroid conditions, but other people as well.  Fortunately, a lot of good information can be obtained by doing a thorough case history and asking the appropriate questions during the initial consultation, which will greatly help in determining which tests are a priority.

How Do You Know Which Tests To Order?

When recommending tests to patients, I typically choose those that are most likely to give me the information I need to find the underlying cause of the condition.  So while all of the tests I listed above can be valuable, some are more important than others.  For example, it’s common for people to have compromised adrenal glands, and this can definitely be a factor in one’s thyroid or autoimmune thyroid condition.  This is one of the reasons I test the adrenals in most people.  The gut also is compromised in a lot of people, and the saliva panel I recommend also tests for secretory IgA, which can give an indication if someone has gut problems, although this doesn’t just relate to the gut.  If the results are inconclusive then I very well might recommend doing a specific test for intestinal permeability.  But if I suspect someone has a leaky gut then another option is for the patient to save the money on additional testing, and just put them on a leaky gut protocol while continuing to monitor their symptoms and the results of the blood and saliva tests.

There are certain tests I would like to do on everyone if they were accurate, but unfortunately this isn’t the case with all of the tests I listed above.  An example of this is food intolerance testing.  Some natural healthcare professionals require all of their patients to obtain a food intolerance panel.  Some examples include the ELISA IgG4 panel and the ALCATZ.  Both of these can provide some valuable information, but they also are notorious for false negatives.  Believe me when I tell you that if food intolerance testing was completely accurate I would recommend this type of testing to everyone so that they would know which foods they should avoid.  The problem is these tests are very expensive, and there is a good chance that there will be some false results, which means the person who gets this test will avoid some of those foods they react to, but not all of them.

Plus, if someone has a leaky gut then these tests can become even more unreliable.  According to Dr. Natasha Campbell-McBride, who is the creator of the GAPS diet, “Testing for food allergies is notoriously unreliable: if one had enough resources to test twice a day for two weeks, they would find that they are ‘allergic’ to everything they eat. As long as the gut wall is damaged and stays damaged, you can be juggling your diet forever removing different foods and never get anywhere. From my clinical experience it is best to concentrate on healing the gut wall. Once the gut wall is healed, the foods will be digested properly before being absorbed, which will remove most food intolerances and allergies.”

What Should Be Done When Some Of The More Important Tests Come Out Negative?

Let’s get back to the main question.  If someone has gone through all of the necessary testing, and everything comes back negative, then what should they do?  Here are a few things I recommend:

1. Make sure all of the necessary testing has been done. When someone tells me they have done all of the necessary tests, sometimes this is true, but other times it isn’t.  So you do want to make sure to at least do some of the more important testing.  Of course one of the challenges is knowing which tests are truly necessary.  To be honest, sometimes even the healthcare professional doesn’t know for certain, as they will initially recommend those tests they feel are necessary, but they might end up recommending other tests at a later date.

2. Make sure the tests have been interpreted correctly. Most of the time this doesn’t seem to be a problem, but every now and then I’ll consult with a patient who worked with a different healthcare professional who didn’t do a good job of interpreting the tests they recommended.  For example, I’ve had some patients who obtained the Adrenal Stress Index test from a different doctor, and their cortisol levels and DHEA were within normal limits, while their secretory IgA was well out of range.  But some doctors aren’t concerned about this as long as the other values for the adrenals look fine.  Similarly, some will do hormone testing and will only look at the LEVELS of estrogen and progesterone, but won’t pay attention to the RATIO of estrogen and progesterone, which is important.  Not too long ago I had a patient whose medical doctor ordered an iron panel, and both the serum iron and % saturation were out of range, and the ferritin was 11 ng/mL, which is extremely low, but was within normal limits according to the lab reference range.  But the medical doctor didn’t tell her anything was wrong, and so the patient assumed that she was fine in this area.

3. Keep in mind of the functional reference ranges for different tests. I just gave an example of the iron panel where ferritin was within the reference range (10 to 150 ng/mL according to that specific lab), but was on the low side at 11 ng/mL.  Ferritin has to do with iron storage, and a low ferritin is the first sign of an iron deficiency.  And so once it dips below 40 to 45 ng/mL there is a cause for concern, even if it is within the lab reference range.  The same thing can be said for 25-OH Vitamin D, as most labs have a reference range of 30 to 100 ng/mL.  But for optimal immune system health you want the levels to be at least 50 ng/mL, and 60 or 70 would be even better.  I’ve given a couple of examples regarding serum tests, but the same concept applies for other tests as well.  For example, if someone does a saliva test to look at the cortisol levels, the cortisol could be within normal limits, but on the low side, which might indicate problems with the adrenals.

4. Re-evaluate and do other tests if necessary. Sometimes it is necessary to do additional testing.  For example, I don’t initially conduct a comprehensive pathogens profile on my patients.  But if someone has gotten to the point where their adrenals and gut appear to be healthy and strong, and if they are still experiencing certain symptoms (i.e. fatigue, bloating/gas, etc.), then I might recommend doing a comprehensive test for pathogens.  Can’t I just include this test initially?  Sure I can, but in addition to this test being expensive, I don’t find this test to be necessary to do initially in most of my patients.  Of course if I do suspect problems with pathogens after going through the initial consultation then I very well might recommend such testing.  Many times if I suspect a pathogen problem I will just put the person on some natural antimicrobials (i.e. garlic, berberine, oregano oil, turmeric, etc.), and then if this doesn’t work a pathogens profile might be necessary to obtain

5. Focus on eliminating toxins. There are numerous tests for toxins available.  For example, one can do testing for heavy metals through the hair or urine.  The company Metametrix has a Toxic Effects Core Profile, which includes about one dozen of the common toxins.  Although I think it’s great that such comprehensive testing for toxins is available, the test is very expensive, and of course doesn’t test for every type of toxin we’re exposed to, but only the most common ones.  I think it’s safe to assume that just about everyone is toxic, and as a result I usually recommend for my patients to do things to help detoxify the liver.  And there are times when people might need to utilize other methods of detoxification such as infrared sauna therapy and/or colon hydrotherapy.  If someone has reached the point where all of the serum and alternative tests look good but they are still symptomatic, I will usually have them focus on eliminating toxins for a few months.  In some cases it can take awhile to greatly reduce one’s toxic load, but hopefully they will at least begin noticing an improvement in their symptoms after a few months.

So if you are experiencing numerous symptoms, yet all of the different tests you obtained were negative, then hopefully the information in this post will be of value.  There obviously is a reason behind someone’s symptoms, and so if everything comes out negative then in most cases it does come down to doing more detective work.  I realize this can be frustrating, and when this happens most medical doctors will simply tell the patient they need to live with the symptoms.  But if this describes your situation then please don’t give up hope, as you need to remember that there always is an underlying cause that is responsible for one’s symptoms.  In some people it can be challenging to find out the cause, but I can assure you that something in the body is out of balance which is responsible for the symptoms.

There are numerous “controversies” when it comes to thyroid health.  And so the goal of this post is to discuss some of the more common controversies.  Although I have my personal biases, and will give you my opinion with regards to each of these “controversies”, my goal isn’t to persuade you to choose one side or the other, but instead is to provide you with some information so you can make an informed decision, or perhaps do some further research on your own.

Controversy #1: Iodine.  This might be the biggest controversy in the world of thyroid health.  Many healthcare professionals will recommend for people with hypothyroid and hyperthyroid conditions to supplement with iodine.  On the other hand, some will advise people with thyroid conditions to stay away from iodine…especially those who have autoimmune thyroid conditions.  I’ve written about iodine numerous times in the past, and I definitely would check out some of my previous articles and posts.

The Case For Iodine Supplementation: Iodine is necessary for the formation of thyroid hormone.  And so if someone has a hypothyroid condition and is deficient in iodine, then it would make sense to correct this deficiency so that the thyroid gland will be able to produce a sufficient amount of thyroid hormone.  But how about those people with hyperthyroidism and Graves’ Disease?  Well, even though this condition involves an excessive production of thyroid hormone, the cause of this is usually an overactive immune system attacking the TSH receptors.  And so in most cases it’s not caused by having too much iodine.  Plus, many years ago iodine in the form of Lugol’s solution was used by medical doctors to treat many cases of hyperthyroidism and Graves’ Disease.

In addition, many people with hyperthyroid conditions have benefited from iodine supplementation.  Besides some of the positive experiences my patients have received when supplementing with iodine, many other people have reported an improvement in their health upon taking iodine supplements.  And while one can make the argument that some of these people were taking numerous other supplements at the same time, many people don’t notice a positive change in their health until they introduce iodine.  In other words, I’ve worked with numerous patients who were taking certain supplements, but once they started taking iodine they began experiencing a big improvement in their health.

For those who question the safety of iodine supplementation, there is no question that a small percentage of people don’t do well when taking iodine.  However, the same can be said with other supplements and herbs as well.  But in most cases, those who have an iodine deficiency and take iodine with the proper precautions experience great benefits.

The Case Against Iodine Supplementation: Although iodine has helped many people with thyroid and autoimmune thyroid conditions, there have been cases when taking iodine has worsened a person’s condition.  There have even been reports of people who didn’t have a thyroid condition until they began taking iodine supplements.  In addition, there is a possibility that iodine can trigger an autoimmune response, thus causing an autoimmune thyroid condition.  While it’s great that many people have taken iodine and have benefited tremendously, what about those people who took iodine and had a negative reaction?

My Opinion About Iodine Supplementation: Those who have been reading my articles and blog posts for awhile know that I’m pro-iodine.  But I also realize that there can be risks with taking iodine, and that iodine isn’t for everyone.  With that being said, most people who react to iodine do so because 1) they take large doses of iodine without getting tested for a deficiency, 2) they don’t take the proper precautions, such as also supplementing with antioxidants such as selenium and vitamin C, as well as magnesium to help with the absorption.   I would encourage you to do some research on your own, and at the same time check out the following two articles I’ve written about iodine:

Can Taking Iodine Cause An Autoimmune Thyroid Condition?

Is Iodine Safe To Take In People With Hyperthyroidism?

Controversy #2: Gluten.  Many people with thyroid and autoimmune thyroid conditions can benefit from avoiding gluten.  Truth to be told, many people without thyroid problems can also benefit from avoiding gluten.  But when should someone avoid gluten?

The Case For Avoiding Gluten: If someone has a gluten sensitivity this can cause numerous problems if the person continues to eat foods which have gluten.  One of the main problems is that gluten can affect the permeability of the small intestine, thus leading to the condition known as leaky gut syndrome.  And while testing for a gluten sensitivity might sound like a good idea, most of the available testing isn’t completely reliable.  And the more accurate testing, such as Cyrex Labs Wheat/Gluten Proteome Reactivity & Autoimmunity test, is quite expensive.  For those who don’t mind spending $300+ on such testing that’s fine.  But it’s definitely less expensive to go on a gluten-free trial.  And quite frankly, most people should be eating whole, healthy foods, which are naturally gluten free.  Many people who are gluten free eat too much processed food, such as gluten free cereal, gluten free cookies, gluten free bread and pasta, gluten free pizza, etc.  I’m not suggesting that having these foods every now and then will cause problems, but many people eat these foods on a daily basis.

The Case Against Avoiding Gluten: When I first began working with people who have thyroid and autoimmune thyroid conditions, I wasn’t as strict when it came to having people avoid gluten.  And many people still received good results.  And so while some people do need to avoid gluten in order to restore their health back to normal, others might not need to completely avoid gluten in order to receive great results.

My Opinion About Avoiding Gluten: Although it’s true that some people who follow a natural treatment protocol who continue to consume foods with gluten will still be able to restore their health back to normal, the question that you need to ask yourself is whether or not consuming gluten on a regular basis is necessary.  Just because you don’t react to something doesn’t mean it should be part of one’s regular diet.  Keep in mind that this is coming from someone who is not completely gluten free, as while I eat mostly whole foods and minimize my consumption of gluten, every now and then I will eat foods which aren’t gluten free.  So I’m not suggesting that everyone needs to permanently avoid gluten, as I think for many people it’s fine to indulge every now and then.  But I do think those following a natural treatment protocol should make a serious attempt to avoid gluten, and even after restoring one’s health back to normal it’s a good idea to minimize your consumption of gluten-based foods.  And of course some people will need to avoid gluten on a permanent basis.

Controversy #3: Goitrogens.  I work with a lot of people who have hypothyroid conditions, and most of these people have Hashimoto’s Thyroiditis.  And many of these people do everything they can to avoid goitrogenic foods, such as broccoli, kale, cauliflower, spinach, strawberries, etc.  In the past I encouraged people with hypothyroidism to avoid goitrogenic foods, as a few years ago I wrote an article entitled “Goitrogens: Thyroid Inhibiting Foods You Should Avoid“.  So should people with hypothyroid conditions avoiding eating these foods?

The Case For Goitrogenic Foods: Many of the goitrogenic foods are very healthy.  Foods such as broccoli, kale, cauliflower, Brussels sprouts, spinach, strawberries, peaches, and other foods have plenty of nutrients which can benefit our health.  And when it comes to the research which talks about the thyroid-inhibiting effects of certain foods, these were performed on rats and mice, but perhaps more important than this is they involved large quantities of these foods.  I’ve never consulted with anyone with hypothyroidism who had their condition develop by eating too much broccoli or kale.  Remember that most people with hypothyroidism have Hashimoto’s Thyroiditis, which is an autoimmune condition that involves destruction of the thyroid gland.  One can argue that eating goitrogenic foods will only worsen one’s hypothyroid condition, but I haven’t found this to be true.  An exception to this might be if someone has an iodine deficiency, but even when this is the case it is controversial as to whether consuming small amounts of goitrogenic foods will inhibit thyroid activity.  For those who remain concerned, keep in mind that cooking these foods will reduce their goitrogenic activity.

The Case Against Eating Goitrogenic Foods: Even if there is only a small chance of goitrogenic foods inhibiting thyroid function, why take the chance and eat these foods?  After all, there are other foods people with hypothyroid conditions can eat, so why not play it safe and avoid those foods which can potentially cause problems with thyroid function…especially if someone already has a hypothyroid condition?

My Opinion About Eating Goitrogenic Foods: Although I don’t encourage people with hypothyroid conditions to eat large amounts of goitrogenic foods, I do think that in most cases, eating a small amount of goitrogenic foods is fine.  I discussed this in further detail in an article I recently wrote entitled “An Update on Goitrogenic Foods and Their Impact On Thyroid Health“.

Controversy #4: Soy.  I realize that soy is also a goitrogenic food, but there is so much controversy over soy and thyroid health that I figured it deserves special attention.

The Case For Eating Soy: There is some evidence that soy can help to prevent certain types of cancer. And eating some organic fermented soy might have other health benefits as well.  For example, there is evidence in animal studies that soy can prevent osteoporosis, although this is inconclusive.

The Case Against Eating Soy: First of all, most soy in the United States is genetically modified.  And so if you are going to eat soy, please make sure it’s GMO-free.  While there might be some health benefits of consuming some organic, fermented soy, this is controversial.  Soy is a goitrogen, and so it can potentially can inhibit thyroid activity, although someone probably will need to eat a large amount of soy for this to happen.  Soy also has antinutrients, such as lectin and protease inhibitors.  And so eating soy can make digestion difficult, and potentially interfere with the absorption of certain nutrients, such as iron.  While there is some evidence that the phytoestrogens of soy has certain health benefits, there is also evidence that it can cause problems, such as infertility.

My Opinion About Eating Soy: Without question, I am opposed to people eating non-organic soy, since most of the soy is genetically modified.  However, I’m also not in favor of people eating large amounts of soy, even if it is organic and fermented.  As for eating small amounts of fermented, organic soy, I think doing this on an occasional basis is fine for most people.  I personally try to avoid soy-based foods, although I do occasionally eat some foods which have organic, fermented soy, and I don’t think having very small amounts of soy will lead to major health problems in most people.  For example, if someone takes a nutritional supplement with organic, fermented soy I think that in most cases this will be fine.  On the other hand, I would be cautious about eating soy-based foods on a regular basis, even if the soy is organic and fermented.

Controversy #5: Fluoride. Although many people (including myself) avoid fluoride, from time to time I’ll have a patient ask whether they should use toothpaste with fluoride, or if it’s okay to drink water that has fluoride.

The Case For Using Fluoride: This honestly will be tough to defend, as I really do feel strongly about intentionally using products which have fluoride.  But I’ll give it a shot.  First of all, millions of people use toothpaste with fluoride and drink fluoridated water, yet many of these people don’t have a thyroid problem.  Plus, even though fluoride can affect thyroid health, it’s probably safe to conclude that most people with hypothyroid conditions didn’t develop this condition due to fluoride exposure.  In addition, thousands of dentists recommend fluoride in order to prevent the formation of cavities.

The Case Against Using Fluoride: There is strong evidence that fluoride can have a negative effect on thyroid health.  In fact, in the past, fluoride was used as a treatment for hyperthyroid conditions by numerous medical doctors.  Even if it really does help to prevent the formation of cavities, one always needs to consider the risks and benefits.  In my opinion we don’t need to use fluoride-based toothpaste and have fluoride in the water to have healthy teeth, and many other healthcare professionals would agree with me.

My Opinion About Using Fluoride: My wife and I have used a fluoride-free toothpaste for many years, and so have our two daughters.  And so I do recommend not using fluoride-based toothpastes, and recommend drinking water without fluoride.  This might mean drinking reverse osmosis or distilled water, or perhaps buying a separate fluoride filter.

In summary, there are numerous controversies in thyroid health, but these are five of the biggest ones.  Although I revealed my personal opinions for each of these, other natural healthcare professionals will argue with my viewpoints.  Many will tell all of their patients with thyroid and autoimmune thyroid conditions to avoid iodine, while others will tell all of their patients to never eat gluten, not to consume any goitrogenic foods, etc.  Some also won’t agree with my perspective involving fluoride, and of course many dentists and numerous other healthcare professionals feel that some fluoride use is beneficial.  The frustrating part is that if you do research on PubMed, or another source, there will be no clear cut answers.  Clinical studies are definitely lacking in these areas, and so ultimately it is up to you to do your own research and decide what is best for your health.